Healthcare losing consumer trust through lack of price transparency
In 1963, Dr. Martin Luther King Jr. rallied support for civil rights by saying that our country could no longer afford the luxury of administering itself “the tranquilizing drug of gradualism.” Instead, King said, we must recognize “the fierce urgency of now.”
That phrase has resonated through the years in many contexts. The issue at hand is healthcare consumer rights, so it’s our turn. In my travels, I hear people say that addressing consumerism is a big job that will take time. That assessment is justifiable. A system designed for transactions between businesses and third-party payers can’t become retail-oriented overnight.
Months pass, other things take precedence, and that nagging feeling persists: We should be moving forward with consumerism. But somehow, it doesn’t rise to the top of the priority list. Meanwhile, third parties continue developing websites and apps with price data likely to be less accurate than information directly from providers or health plans. Before we know it, years go by, and we have made little progress.
In fact, we are actually losing ground. We are losing the trust of our customers—our patients, our most important asset—and not only from a loyalty standpoint.
As population health management takes hold, patient engagement is critical, especially for those with chronic conditions. Yet, new proprietary research conducted by Nielsen/Harris Interactive’s Strategic Health Perspectives shows that patients who need healthcare consumerism the most— those who have significant out-ofpocket expenses and are concerned about their ability to pay—are increasingly feeling disempowered, if not downright hopeless about the healthcare system. The number of these atrisk consumers who reported feeling powerless went up from 23% in 2014 to 31% in 2015; the proportions who said they felt resigned, depressed and angry also increased.
Common sense tells us that depressed, resigned consumers are not going to use transparency tools. Neither will they make optimal healthcare decisions. They’re just not equipped to be full partners in their care.
We should act now to bring these disengaged consumers back into the fold—and to maintain the trust of others. The first step is to change our mindset. Let’s agree that it’s reasonable for consumers to expect accurate information about what they’re expected to pay out of pocket. Let’s further agree that consumers shouldn’t have to hunt down information about financial assistance or feel any stigma about it. Finally, let’s agree to recognize the fierce urgency of now. The longer we wait, the more we stand to lose. Once there is consensus, the action plan is straightforward:
Collaborate. No group can deliver on price transparency alone. Health plans are well-equipped to provide price information to their members. Consumers who are uninsured or seeking care out of network will naturally look to providers for price information. If providers and health plans work together, they can cover all the bases. A multi-organizational task force convened by the Healthcare Financial Management Association last year came to these conclusions. The report can be found at hfma.org/transparency.
Prioritize. Aggregating chargemaster items into understandable procedure-level prices, when appropriate, would be an improvement. Also, keep in mind that most utilization typically represents a small percentage of line items. Focus initial transparency efforts on common procedures or price- sensitive services. One aspect to prioritize across the board is communication. When your frontline staff talk with patients, are they covering the right topics? Are they conveying respect and empathy? Their roles have changed significantly. Make sure they receive training to handle their expanded responsibilities. They are the front door of your organization.
Learn from the experts. For most of us, consumer engagement is not a core competency. Recognizing the lessons to be learned from retail, Providence Health & Services in the Pacific Northwest recruited a senior executive from Amazon to help guide the organization’s approach in this arena. Others would do well to look outside of healthcare for ideas and expertise.
Decades ago, the U.S. auto industry was shaken out of its complacency by disruptive competition from Japan. It changed the industry rapidly and forever. New healthcare competitors who understand the consumer space well are poised to meet consumer needs if traditional providers can’t or won’t.
That’s the fierce urgency of now. Those who understand history have the best chance to avoid repeating it.
Joseph Fifer is president and CEO of the Healthcare Financial Management Association.